Many of the displaced from South Waziristan are now in Dera Ismail Khan
As the conflict between the Taliban and Pakistan's army in the Swat valley drew to a close, the military shifted its focus to the tribal district of South Waziristan where it is currently targeting Taliban strongholds. The BBC's Syed Shoaib Hasan recently met residents fleeing the army's latest offensive.
In South Waziristan, Pakistan's security forces have a directive to "eliminate" the Taliban commander Baitullah Mehsud and his organisation.
And as the operation has got under way, the area has seen fierce aerial bombardment and artillery barrages on militant strongholds.
Many of these are located close to civilian areas and thousands of people have fled.
"I had to walk for seven hours with my family until I got transport out of the war zone," says Mohammad Usman.
Mr Usman is a resident of the South Waziristan town of Makeen. He and his family ran a prosperous fruit shop in the town's main market. They also owned some land which they cultivated.
But once the fighting started they had no option but to flee. There were eight of them altogether and they fled even as the bombs began to pound the area.
"We had to leave most of our belongings behind.
"After seven hours we reached Razmak from where we got transport to Miranshah and then onto Bannu.
"We then walked for three days from Miranshah to get to Dera Ismail Khan where we arrived on 16 May."
Mr Usman said that everybody in his area fled once the bombing began.
"The Taliban have gone up into the hills and most of the casualties have been civilians," he said.
Leaving the area was the only choice for people like him.
"At least 70,000 people have left the war zone for [the town of] Dera Ismail Khan," says Zafar Mehsud, head of a local relief organisation.
Mr Mehsud works for the Al-Khidmat Islamic charity and he says that refugees are continuing to flood into the district as fighting continues.
Zafar Mehsud says most refugees refuse to enter camps
"We have set up camps in various areas of the city, where we are registering the displaced and distributing relief goods."
But he adds more help is needed from official quarters.
"So far the government has not started to deal with this problem seriously."
These sentiments were echoed by Abdur Rauf Khan, mayor of Dera Ismail Khan, who says that the responsibility for matters relating to the displaced has shifted to central government.
But, Mr Khan adds, while he has no authority in the matter, he would like to appeal to the district residents "to welcome and help the displaced".
But there is one outstanding issue of concern and that is identifying who the real refugees are.
"As far as I know, there is no real settlement of refugees in Dera Ismail Khan," the mayor says.
"This is because most of the people who have migrated are living with their relatives," he explains.
This is the crux of the problem - and it makes it difficult to reach out to the refugees.
"These people are not like those from Swat," explains a relief worker.
"They will only go to camps if they are faced with total death and destitution - the Mehsud tribal pride allows them no other choice."
Many of those who live in South Waziristan are also part of the large Mehsud tribe, which is the same tribe that Pakistan's Taliban commander Baitullah Mehsud comes from.
Their ancestral homeland lies in the mountainous terrain of South Waziristan and those who have been forced to flee because of the anti-Taliban offensive are loath to accept state help.
Mohammad Rafiq is a 16-year-old from the sub-division of Tiarza in South Waziristan.
He left with his 15-member family after the Taliban and the military started fighting around mid-May.
"We are now living in a house here we have rented at exorbitant rates," he says.
Zafar Mehsud confirms that local rents have skyrocketed as landlords take advantage of the displaced people
"My father is very unwell and my elder brother and me work as fruit vendors here," Mr Rafiq continues.
"I also attend school, but it's difficult. The police harass us here all the time.
"They say you [Mehsuds] are terrorists and you should leave this place," he says.
Mr Usman has had similar experiences. Working as a labourer, he is barely able make ends meet - but he resolutely refuses to live in a camp.
The government has started responding to the situation - but too slowly for many.
In the late afternoon, after the blistering heat has receded, dozens of Mehsud tribesmen gather outside a goverment registration point on the outskirts of Dera Ismail Khan.
Most of the tribesmen are angry at the government who, they believe, is targeting the entire Mehsud tribe.
They say the younger tribesmen are harassed for being "terrorists".
"We have received no aid so far from anyone," says Haji Murad Khan, a school teacher from Kotkai.
"We fend for ourselves through labour and whatever else we can....only Allah cares for us.
"I don't think this situation [in the tribal areas] is ever going to be resolved in our lifetime," he said.
"This is the third time I have had to move, and now I have no intention of going back."